Axillary lymphadenopathy at the time of COVID-19 vaccination: Ten recommendations from the European Society of Breast Imaging (EUSOBI) Guidelines


Authors: Schiaffino, S.; Pinker, K.; Magni, V.; Cozzi, A.; Athanasiou, A.; Baltzer, P. A. T.; Camps Herrero, J.; Clauser, P.; Fallenberg, E. M.; Forrai, G.; Fuchsjäger, M. H.; Helbich, T. H.; Kilburn-Toppin, F.; Kuhl, C. K.; Lesaru, M.; Mann, R. M.; Panizza, P.; Pediconi, F.; Pijnappel, R. M.; Sella, T.; Thomassin-Naggara, I.; Zackrisson, S.; Gilbert, F. J.; Sardanelli, F.
Title: Axillary lymphadenopathy at the time of COVID-19 vaccination: Ten recommendations from the European Society of Breast Imaging (EUSOBI)
Abstract: Unilateral axillary lymphadenopathy is a frequent mild side effect of COVID-19 vaccination. European Society of Breast Imaging (EUSOBI) proposes ten recommendations to standardise its management and reduce unnecessary additional imaging and invasive procedures: (1) in patients with previous history of breast cancer, vaccination should be performed in the contralateral arm or in the thigh; (2) collect vaccination data for all patients referred to breast imaging services, including patients undergoing breast cancer staging and follow-up imaging examinations; (3) perform breast imaging examinations preferentially before vaccination or at least 12 weeks after the last vaccine dose; (4) in patients with newly diagnosed breast cancer, apply standard imaging protocols regardless of vaccination status; (5) in any case of symptomatic or imaging-detected axillary lymphadenopathy before vaccination or at least 12 weeks after, examine with appropriate imaging the contralateral axilla and both breasts to exclude malignancy; (6) in case of axillary lymphadenopathy contralateral to the vaccination side, perform standard work-up; (7) in patients without breast cancer history and no suspicious breast imaging findings, lymphadenopathy only ipsilateral to the vaccination side within 12 weeks after vaccination can be considered benign or probably-benign, depending on clinical context; (8) in patients without breast cancer history, post-vaccination lymphadenopathy coupled with suspicious breast finding requires standard work-up, including biopsy when appropriate; (9) in patients with breast cancer history, interpret and manage post-vaccination lymphadenopathy considering the timeframe from vaccination and overall nodal metastatic risk; (10) complex or unclear cases should be managed by the multidisciplinary team. © 2021, The Author(s).
Keywords: magnetic resonance imaging; mammography; lymphadenopathy; covid-19 vaccines; ultrasonography (breast)
Journal Title: Insights into Imaging
Volume: 12
ISSN: 1869-4101
Publisher: SpringerOpen  
Date Published: 2021-08-20
Start Page: 119
Language: English
DOI: 10.1186/s13244-021-01062-x
PROVIDER: scopus
PMCID: PMC8378785
PUBMED: 34417642
DOI/URL:
Notes: Article -- Export Date: 1 September 2021 -- Source: Scopus
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